نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار گروه روان‌شناسی دانشگاه پیام نور، ایران

2 کارشناس ارشد روانشناسی، دانشگاه آزاد اسلامی بندرگز، گلستان، ایران.

چکیده

هدف از پژوهش حاضر مقایسه اثربخشی درمان مبتنی بر پذیرش و تعهد و شناخت­درمانی مبتنی بر ذهن‌آگاهی بر میزان افسردگی و دردهای مزمن در زنان مورد همسرآزاری شهرستان گرگان بود. این پژوهش نیمه‌آزمایشی از نوع پیش‌آزمون- پس‌آزمون با گروه گواه بود. حجم نمونه شامل 30 نفر بود که به روش نمونه‌گیری هدفمند، انتخاب شدند و از این تعداد، 10 نفر به گروه آزمایش درمان مبتنی بر پذیرش و تعهد، 10 نفر به گروه آزمایش ذهن‌آگاهی و 10 نفر به گروه گواه به صورت تصادفی ساده گمارده شدند. جهت جمع‌آوری داده‌های پژوهش از سیاهه افسردگی بک و دردهای مزمن، استفاده شد. گروه‌های آزمایش برنامه آموزش مبتنی بر پذیرش و تعهد و شناخت­درمانی مبتنی بر ذهن‌آگاهی 8 جلسه مداخله 1 ساعته دریافت کردند. جهت تحلیل داده‌ها از تحلیل کوواریانس چندمتغیری استفاده شد. نتایج نشان داد هر دو رویکرد درمانی در مرحله پس‌آزمون بر افسردگی و درد مزمن زنان مورد همسرآزاری تأثیر معنی‌داری داشته‌اند (05/0>p). بین دو روش درمانی در هر یک از متغیرهای وابسته تفاوت معنی‌داری مشاهده نشد. بر اساس یافته‌ها می‌توان گفت که هر دو رویکرد درمان مبتنی بر پذیرش و تعهد و شناخت­درمانی مبتنی بر ذهن‌آگاهی می‌توانند به عنوان مداخله‌ای مؤثر برای کمک به زنان مورد همسرآزاری جهت کاهش افسردگی و درد مزمن مورد استفاده قرار گیرد.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison of the Effectiveness of Acceptance-Based Therapy and Mindfulness-Based Cognitive Therapy on the Rate of Depression and Chronic Pain in Abused Women

نویسندگان [English]

  • mojtaba aghili 1
  • narges khatoon arbabi 2

1 Assistant Professor, Department of Psychology, Payame Noor University, Iran.

2 : Master of Psychology, Islamic Azad University of Bandar-e-Gaz, Golestan, Iran.

چکیده [English]

Introduction
Domestic violence is a serious issue that can occur in any intimate or family relationship. The most common type of domestic violence is spousal abuse or husband violence against women. Spousal abuse can take many forms such as physical, sexual, emotional, or financial violence, and it can occur at any time and in any place. Based on various studies on the effectiveness of mindfulness and acceptance and commitment-based therapies in reducing depressive symptoms and chronic pain, the question arises as to which of the two methods is more effective, and whether the combination of these two treatments could be more effective. However, it is not yet clear whether one therapy is more effective than the other, or whether a combination of both therapies is more effective in reducing depression and chronic pain in abused women.
 
Method
A quasi-experimental pretest-posttest design with a control group was used in this study. The statistical population of the study consisted of all women who were abused by their spouse and had a file in the Welfare Office. One group received acceptance and commitment-based therapy, another received mindfulness-based therapy, and the third group was the control group. All three groups completed pre-tests and post-tests using the Depression Inventory and the Chronic Pain Questionnaire, with the experimental groups receiving 8 sessions of 60 minutes each. The inclusion criteria included married women aged between 25 and 35 years, with a minimum diploma education, a score higher than the cut line (18) in the depression list, and victims of physical violence by their spouse at medical diagnosis. The exclusion criteria included reluctance to participate in the investigation and absence for more than two sessions. The research data were analyzed using multivariate analysis of covariance and comparison of means using SPSS software version 24.
 
Results
The results showed that both therapeutic approaches significantly reduced depression and chronic pain in abused women (p<0.05). However, there was no significant difference between the two intervention methods in reducing depression and chronic pain.
 
Conclusion
The findings of the study suggest that acceptance-based therapy and mindfulness-based cognitive therapy are effective in reducing depression and chronic pain in women who have experienced spousal abuse. There was no significant difference between the effectiveness of the two therapies in reducing depression and chronic pain. The study highlights the importance of providing access to effective therapies for women who have experienced spousal abuse.

کلیدواژه‌ها [English]

  • Chronic pain
  • depression
  • mindfulness
  • spousal abuse
Alangeal, O., Addo-Lartey, A., Sikweyiya, Y., Chirwa, D., & Coker-Appiah, D. (2018). Prevalence and risk factors of intimate partner violence among women in four districts of the central region of Ghana: Baseline findings from a cluster randomised controlled trial. PLoS ONE, 13(7), 133-149.
Arnau, C., Meagher, W., Norris, P., & Bramson, P. (2001). Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients. Health Psychology, 20, 112-119.
Amiri, S., Golduzian, A., & Atasheneh, M. (2021). Spouse abuse against women and ways to prevent it based on social theories. Scientific Journal of Women and Culture, 13(49), 109-122. [Persian]
Bradbury-Jones, C., & Isham, L. (2020). The pandemic paradox: The consequences of COVID-19 on domestic violence. Journal of Clinical Nursing, 29(13–14), 2047-2049.
Bunyathikan, T., Soonthornchaiya, R., & Charenboon, T. (2020). The effects of an acceptance and commitment therapy program on the depressive symptoms of elderly patients with major depressive disorder. The Journal of Psychiatric Nursing and Mental Health, 34(2), 118-131.
Beck, T., Epstein, N., Brown, G., & Steer, R.A. (1988). An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol, 56, 893-897.
Dehghani, M., & Aslani, K. (2020). Comparison of the effectiveness of couple therapy based on attachment injury treatment model with integrated couple therapy on forgiveness in women affected by marital infidelity. Journal of Applied Psychology, 14(2), 171-147. [Persian]
Dunning, L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., & Dalgleish, T. (2019). Research Review: The effects of mindfulness based interventions on cognition and mental health in children and adolescents–a meta analysis of randomized controlled trials. Journal of Child Psychology and Psychiatry, 60(3), 244-258.
Dabson, K., Mohammadkhani, P., & Massah-Choulabi, O. (2007). Psychometrics Characteristic of Beck Depression Inventory-II in Patients with Magor Depressive Disorder. Jrehab, 8(1), 82-90. [Persian]
D'Iuso, A., Dobson, S., Beaulieu, L., & Drapeau, M. (2018). Coping and interpersonal functioning in depression. Canadian Journal of Behavioral Science/Revue Canadienne des Sciences du Comportment, 50(4), 248-255.
Dasarband, B., Panaghi, L., & Mutabi, A. (2017). The relationship between spouse abuse and depressive symptoms in female victims: The moderating role of personality traits. Iranian Psychiatry and Clinical Psychology, 23(1), 49-38. [Persian]
Esfandiari Bayat, D., Asadpour, I., Mohsenzadeh, F., & Kasai, A. (2021). Comparison of the effectiveness of group counseling with a rational-emotional-behavioral approach and treatment based on acceptance and commitment on the forgiveness of women affected by marital infidelity. Journal of Psychological Sciences, 20(97), 148-139. [Persian]
Farhangi, A. (2019). The effectiveness of mindfulness-based cognitive therapy for chronic pain control on psychosocial function in women with breast cancer. Quarterly Journal of Excellence in Counseling and Psychotherapy, 8(30), 11-28. [Persian]
Farhadi, M., Yarmohammadi Vasel, M., Zoghi Paydar, M., & Chegini, A. (2017). The effect of hypnotherapy based on ego empowerment on major depression in female-headed households. Journal of Psychological Achievements, 24(1), 63-78. [Persian]
Flujas-Contreras, M., & Gomez, I. (2018). Improving flexible parenting and Depression with acceptance and commitment therapy: A case study. Journal of Contextual Behavioral Science, 8(1), 29-35.
Fielding, R., & Wong, S. (2012). The co-morbidity of chronic pain, insomnia, and fatigue in the general adult population of Hong Kong: Prevalence and associated factors. Journal of Psychosom Res, 73(1), 28-34.
Goudarzi, M., Ghasemi, N., Mirderikvand, F., & GholamreZaei, S. (2018). The Effectiveness of cognitive therapy based on mindfulness on positive affect, psychological flexibility and mind-awareness components of people with depression symptoms. Shenakht Journal of Psychology and Psychiatry, 5(5), 53-68. [Persian]
Golestani Far, S., & Dasht Bozorgi, Z. (2020). The effectiveness of acceptance and commitment-based therapy on depression, mental health and life expectancy of the elderly with nonclinical depression. Psychology of Aging, 6(3), 191-203. [Persian]
Honarparvaran, N., Mirzaei Kia, H., Nayeri, A., & Lotfi, M. (2017). Acceptance and commitment treatment. Tehran: Hamnashin Publications. [Persian]
Hayes, C. (2019). Acceptance and commitment therapy: towards a unified model of behavior change. World Psychiatry, 18(2), 226-227.
Hayes, C., Luoma, B., Bond, W., Masuda, A., & Lillis, J. (2016). Acceptance and commitment therapy: Model, processes and outcomes. Behavior Research and Therapy, 44(1), 1-25.
Hess, D. (2018). Mindfulness-based interventions for hematology and oncology patients with pain. Hematology/Oncology Clinics, 32(3), 493-504.
Johari Fard, R. (2013). The effect of group cognitive-behavioral therapy in patients with generalized anxiety disorder. Master Thesis, Faculty of Educational Sciences and Psychology, Shiraz University. [Persian]
Johannsen, M., O’connor, M., O’toole, M., Jensen, A., & Zachariae, R. (2018). Mindfulness-based Cognitive Therapy and Persistent Pain in Women Treated for Primary Breast Cancer. The Clinical Journal of Pain, 34(1), 59-67.
Kaviani, H., Hatami, N., & Shafieabadi, A. (2009).  The impact of mindfulness-based cognitive therapy on the quality of life in non-clinically depressed people. Advances in Cognitive Sciences, 10(4), 39-48. [Persian]
Khodaei, A., Bagheri, M., & Khosropour, F. (2020). The relationship between self-awareness and self-differentiation with borderline personality traits through the mediating role of mood dysphoria. Journal of Psychological Achievements, 27(2), 49-68. [Persian]
Kiani, S., Sabahi, P., Makvand Hosseini, Sh., Rafieinia, P., & Al-Bouyeh, M. (2020). Comparison of the effectiveness of acceptance and commitment-based therapy and positive cognitive-behavioral therapy on psychological disorders in patients with chronic pain. Journal of Health Psychology, 9(36), 133-150. [Persian]
McDermott, K., Griffin, M., McHugh, R., Fitzmaurice, G., Jamison, R., Provost, S., & Weiss, R. (2019). Long-term naturalistic follow-up of chronic pain in adults with prescription opioid use disorder. Drug and Alcohol Dependence, 205(3), 107675.
Mathur, S., Sharma, M., & Bharath, S. (2020). Mindfulness-based cognitive therapy in patients with late-life depression: A case series. Int J Yoga, 9(2), 168-72.
Mozafari-Motlagh, M., Nejat, H., Tozandehjani, H., & Samari, A. (2020). Effectiveness of mindfulness-integrated cognitive-behavioral therapy in breast cancer pain management. Ijbd, 13(1), 35-45. [Persian]
Nieuwsma, A., Walser, D., Farnsworth, K., Drescher, D., Meador, G., & Nash, W. (2015). Possibilities within acceptance and commitment therapy for approaching moral injury. Current Psychiatry Reviews, 11(3), 193-206.
Osati, K., & Salehi, M. (2020). The effectiveness of mindfulness-based therapy on depressive, anxiety and stress symptoms in patients with gender boredom disorder. Clinical Psychology, 12(2), 63-70. [Persian]
O'Loughlin, I., & Newton-John, T. R. (2019). ‘Dis-comfort eating’: An investigation into the use of food as a coping strategy for the management of chronic pain. Appetite, 140, 288-297
Patel, R., Weobong, B., Patel, H., & Singla, D. R. (2019). Psychological treatments for depression among women experiencing intimate partner violence: findings from a randomized controlled trial for behavioral activation in Goa, India. Arch Women Ment Health, 22(1), 1-11.
Pedler, A., Kamper, S. J., Maujean, A., & Sterling, M. (2018). Investigating the fear avoidance model in people with whiplash. The Clinical Journal of Pain, 34(2), 130- 137.
Roesch, E., Amin, A., Gupta, J., & García-Moreno, C. (2020). Violence against women during covid-19 pandemic restrictions. The British Medical Journal, 369(1), 21-30.
Rakovec-Felser, Z. (2017). Domestic violence and abuse in intimate relationship from public health perspective. Health Psychol Res, 2(3), 1821-1834.
Razavi, B., Abolghasemi, S., Akbari, B., & Naderinabi, B. (2019). Effectiveness of Acceptance and Commitment Therapy on Feeling Hope and pain management of Women with Chronic Pain . JAP, 10(1), 36-49. [Persian]
Shirazi Tehrani, A., Mirdrikond, F., & Sepahvandi, M. (2017). Develop a structural model for predicting chronic musculoskeletal pain through coping skills, catastrophizing, fear, severity and disability. Anesthesia and Pain, 7(4), 92-106. [Persian]
Stein, T., Freeman, Z., & Smits, A. (2019). Cognitive mechanisms underlying the link between anxiety, health behaviors, and illness outcomes: commentary on a special issue. Cognitive Therapy and Research, 43(1), 131-138.
Swain, J., Hancock, K., Dixon, A., Koo, S., & Bowman, J. (2013). Acceptance and commitment therapy for anxious children and adolescents: Study protocol for a randomized controlled trial. Trials, 14, 140.
Siddiq Rad, Gh., Askari, P., Heydari, A., & Siraj Khorami, N. (2021). The effectiveness of commitment and acceptance therapy (ACT) in reducing impulsive behaviors, mood disorders and hopelessness in depressed patients in counseling centers in Ahvaz. Journal of Psychological Achievements, 28(2), 201-218. [Persian]
Sobhani, E., Babakhani, N., & Alebouyeh. M . (2019). The effectiveness of mindfulness-based stress reduction on the depression, anxiety, stress, and pain perception in females with obstructed labor-induced chronic low back pain. IJPCP, 25(3), 266-277. [Persian]
Stefan, L., Coulter, M., & Vande Weerd, C. (2016). Depression in women who have left violent relationships: The unique impact of frequent emotional abuse. Violence Against Women, 12(11), 1413-1419.
Tesidebel, N., & Viliams, K. (2015) Mindfulness cognitive therapy for depression. New York: Jones & Bartleth - Publishers.
Taheri, S., & Sajjadian, I. (2018). The effectiveness of mindfulness-based cognitive therapy on fatigue, anxiety and depression in employees with chronic fatigue syndrome. Journal of Psychological Achievements, 25(2), 129-150. [Persian]
Twohig, P. (2012). Acceptance and commitment therapy: Introduction. Cognitive and Behavioral Practice, 19(4), 499-507.
Vakilian, L., Tarkhan, M., & Khalatbari, J. (2020). Predicting emotional malaise based on early maladaptive schemas and perfectionism with mediating the role of cognitive flexibility in patients with chronic pain. Thought and Behavior in Clinical Psychology, 15(57), 77-84. [Persian]
Vesal, M., & Taher Neshat Doost, H. (2019). Meta-analysis of the effectiveness of psychological therapies for chronic pain on pain relief (Articles 97-85). Anesthesia and Pain, 10(3), 38-21. [Persian]
Van Korff, M., Dworkin, F., & Resche, L. (1990). Graded chronic pain status: An epidemiologic evaluation. Pain, 40(3), 279-291.
Validi Pak, A., Khodai, A., & Sheykhaleh, S. (2020). Effectiveness of cognitive-based mindfulness training of depression reduction on patient suffering from cancer. Clinical Psychology and Personality, 14(2), 49-57. [Persian]
Williams, R., Murphy, M., Dore, A., Evans, K., & Zonderman, B. (2018). Intimate partner violence victimization and cognitive function in a mixed-sex epidemiological sample of urban adults. Violence and Victims, 32(6), 11-21.
Wetherall, K., Robb, K. A., & O'Connor, R. C. (2019). Social rank theory of depression: A systematic review of self-perceptions of social rank and their relationship with depressive symptoms and suicide risk. Journal of Affective Disorders, 246, 300-319.
Yasaei, M., Shafei Abadi, A., & Farzad, V. (2018).Comparison of the effectiveness of acceptance and commitment-based therapy (ACT) with mindfulness based cognitive therapy (MBCT) on anxiety and depression in hemodialysis patients. Journal of Principles of Mental Health, 19(3), 268-277. [Persian]
Zadeh Mohammadi, A., & Kordestanchi Aslani, H. (2021). The mediating role of cognitive emotion regulation in the relationship of early maladaptive schemas with spouse abuse. IJPCP, 26(4), 502-523. [Persian]